Tag: pubmed

Neurosurg Rev. 2025 Jun 21;48(1):523. doi: 10.1007/s10143-025-03673-0.

ABSTRACT

Decompressive craniectomy is a key treatment for refractory intracranial pressure after severe traumatic brain injury (TBI). Post-traumatic hydrocephalus (PTH) occurs in 7.6-36% of cases, and early diagnosis significantly improves rehabilitation outcomes. This retrospective study analyzed risk factors for shunt-dependent PTH in 126 TBI patients (93 men, 33 women, median age 53 years). Patients were divided into those requiring shunts and those who did not. Clinical and radiological characteristics, including volumetric measurements and surgical techniques, were assessed using SPSS^® Statistics 25. The incidence of shunt-dependent PTH was 27%. Multivariate analysis identified significant risk factors: advanced age at craniectomy (p = 0.008; OR 1.048), traumatic subarachnoid hemorrhage in the basal cisterns (p = 0.015; OR 7.545), post-traumatic ischemic infarcts (p = 0.003; OR 5.319), transcalvarial brain herniation (p = 0.012; OR 5.543), subdural hygroma (p = 0.004; OR 8.131), and progression of contusion hemorrhages (p = 0.013; OR 4.386). Operative parameters did not show statistical significance. Neurological outcomes in shunt patients, assessed via the modified Rankin Scale and Extended Glasgow Outcome Scale, were significantly worse than in non-shunt patients (mRS > 3, GOS-E < 5, p = 0.001-0.011). Our findings suggest that subarachnoid hemorrhage in the cisterns, advanced age, hygromas, ischemic infarcts, transcalvarial herniation, and contusion hemorrhage progression are independent risk factors for shunt-dependent PTH. Additionally, shunt placement was linked to poorer neurological outcomes.

PMID:40542880 | DOI:10.1007/s10143-025-03673-0

Abdom Radiol (NY). 2025 Jun 21. doi: 10.1007/s00261-025-05054-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the utility and complications of urethrosonography (US) in the preoperative assessment of urethral stricture compared to traditional diagnostic methods and its impact on therapeutic decision-making.

METHODS: A prospective observational study was conducted on male patients diagnosed with urethral stricture who were candidates for surgical treatment. Preoperative assessment included flexible urethrocystoscopy, voiding cystourethrography (VCUG), and US. Demographic and epidemiological data were recorded and analyzed. Sensitivity and specificity were calculated. Agreement between diagnostic techniques was assessed using the Cohen’s Kappa coefficient. The impact of findings on surgical decision-making was evaluated, and potential complications associated with each technique were documented.

RESULTS: Thirty-three male patients with a mean age of 59.5 years, diagnosed with urethral stricture who were candidates for surgical treatment, were evaluated. No statistically significant differences were found in the location or severity of the stricture among the different techniques, with good concordance with intraoperative findings. US demonstrated higher sensitivity (60% vs. 44.2%) and specificity (87.8% vs. 84.9%) compared to VCUG in assessing the length of the stricture, and was also more accurate than urethrocystoscopy in determining the degree of spongiofibrosis (77.02% vs. 69.11% for sensitivity, and 81.9% vs. 74.5% for specificity). The choice of preoperative technique influenced the selection of the surgical approach.

CONCLUSIONS: Urethrosonography is more sensitive and specific than traditional techniques in determining the length of the stricture, with similar concordance with intraoperative findings. It may serve as an alternative to conventional diagnostic tests in the preoperative evaluation of urethral stricture, offering several advantages such as the absence of radiation, lower complication rates, and its non-invasive nature.

PMID:40542876 | DOI:10.1007/s00261-025-05054-z

Support Care Cancer. 2025 Jun 21;33(7):609. doi: 10.1007/s00520-025-09673-6.

ABSTRACT

PURPOSE: This study analyzed the relationship between different levels of sleep difficulties and physical, mental, and emotional variables in long-term breast cancer survivors (LTBCSs), and identified predictors of sleep-related complaints.

METHODS: Eighty LTBCSs participated in this cross-sectional study. Sleep difficulties were assessed via item 11 of the EORTC QLQ-C30, classifying participants into two groups: low (n = 44; ≤ 26.29) and high sleep difficulties (n = 36; ≥ 26.30). Additional measures included the EORTC QLQ-BR23, Piper Fatigue Scale, Visual Analog Scale, Brief Pain Inventory, International Fitness Scale, Minnesota Leisure Time Physical Activity questionnaire, and the Scale for Mood Assessment. Statistical analyses comprised ANOVA, Mann-Whitney U, Chi-square, correlation, and multiple regression; effect sizes were calculated using Cohen’s d.

RESULTS: Fifty-five percent of LTBCSs reported higher sleep difficulties. This group showed greater physical, mental, and emotional impairments, including cancer-related fatigue (CRF), pain, lower self-perceived fitness, reduced physical activity (PA), worse mood, and diminished health-related quality of life (HRQoL) (all p < 0.05). Regression identified “role functioning” (β = -0.37; p < 0.01), “nausea and vomiting” (β = 0.37; p < 0.01), and “PA level” (β = -0.17; p = 0.02) as significant predictors of higher levels of sleep difficulties (adjusted r² = 0.58).

CONCLUSION: Five or more years post-diagnosis, 55% of LTBCSs experienced higher sleep difficulties, associated with poorer HRQoL, self-perceived physical fitness, mood, and increased CRF and pain. Key predictors explained 58.4% of variance in sleep difficulties.

PMID:40542861 | DOI:10.1007/s00520-025-09673-6

Graefes Arch Clin Exp Ophthalmol. 2025 Jun 21. doi: 10.1007/s00417-025-06867-w. Online ahead of print.

ABSTRACT

PURPOSE: To study the properties of different ophthalmic viscosurgical devices (OVD) in respect of their ability to create and maintain high intraocular pressure (IOP) during the creation of a continuous curvilinear capsulorhexis (CCC).

METHODS: In this randomized interventional study IOP was measured using rebound tonometry with sterilized probes immediately before the beginning of the CCC and immediately afterwards during cataract surgery. The study included 177 eyes in four groups using two different OVD – hyaluronic acid (HA) and a combination of HA and hydroxy propylmethylcellulosis (HPMC) according to the soft shell-technique (SST) – and two different instruments, Utrata forceps (UF) and 26 g cystotome (RN).

RESULTS: The drop in intraocular pressure (IOP) during capsulorhexis was measured at 57.0 ± 12.2 mmHg in eyes treated with HA (90) and 63.1 ± 13.4 mmHg in eyes treated with SS (87). The difference in IOP reduction between HA and SS did not reach statistical significance (p = 0.060).

CONCLUSIONS: The use of different OVD did not result in a significant difference in IOP drop. As the soft shell-technique has shown superiority in respect of endothelial protection, these results should encourage cataract surgeon to resort to the soft shell-technique more often if not use it as a standard technique.

PMID:40542859 | DOI:10.1007/s00417-025-06867-w

Antimicrob Resist Infect Control. 2025 Jun 20;14(1):70. doi: 10.1186/s13756-025-01590-x.

ABSTRACT

BACKGROUND: Understanding the impact of catheter dwell time on the risk of central-line associated bloodstream infections (CLABSIs) is crucial to developing effective infection prevention strategies. The aim of the study was to evaluate the relationship between catheter dwell time and the risk of CLABSIs caused by multidrug-resistant and common pathogens in patients with central venous catheters (CVCs) and peripherally inserted central catheters (PICCs).

METHODS: We retrospectively analysed data from patients admitted consecutively to a tertiary care Greek hospital from 2018-2020. Events were categorized into three groups based on 10-days’ intervals: group 1 (≤ 10 days), group 2 (11-20 days), and group 3 (> 21 days).

RESULTS: Α total of 84 patients (mean age 56.4 ± 19.6 years) were included in the study. Among them, 62 (73.8%) had CVC, while 22 (26.2%) had PICC placement. In the CVC cohort, a statistically significant difference in CLABSI rates was observed, with rates of 4.49, 5.57, and 8.54 per 1,000 catheter/days for groups 1, 2, and 3 respectively (p < 0.001). Similarly, higher rates of MDROs were found in group 3, with rates of 2.93, 3.71, and 4.47 per 1,000 catheter/days for groups 1, 2, and 3, respectively (p = 0.01). Regarding the PICC cohort, significant differences in CLABSI rates were observed among the three groups, with rates of 0.93, 2.25, and 1.67 per 1,000 catheter/days for groups 1, 2, and 3, respectively (p < 0.001).

CONCLUSION: Our results emphasize the critical role of catheter selection and duration management in mitigating CLABSI risk, especially for patients with CVCs.

PMID:40542449 | DOI:10.1186/s13756-025-01590-x

Neurol Res Pract. 2025 Jun 20;7(1):42. doi: 10.1186/s42466-025-00398-9.

ABSTRACT

BACKGROUND: An analysis of the cerebrospinal fluid (CSF) is essential for diagnosis of meningitis, headache, disturbance of conscience, cranial nerves or autoimmune-related conditions of the CNS. The initial treatment of pleocytosis usually consists of both antiviral therapy and antibiotics until laboratory results enable a more specific approach. Therefore, it is crucial to rapidly and accurately detect pathogens.

METHODS: In this observatory, monocentric study of quality management data, we studied insourcing of ME-PCR, CXCL 13, Antibody-specific Index (AI) for HSV, VZV (G $_1^{}$ ) compared with outsourced laboratory measurements (G $_0^{}$ ) and its benefit for the work-up. Before the implementation of these parameters, data from 150 patients were sampled, followed by 210 after the introduction of ME-PCR, CXCL 13 and AI. Data were collected, anonymized, and analysed afterwards. All were treated in hospital for suspected infections of the Central Nervous System (CNS). The length of hospital stay (LOS), intervals from lumbar puncture, the cumulative dose of anti-infective agents, length of treatment and the potential impact on patients’ safety parameters were examined.

RESULTS: The G $_1^{}$ -group showed a significant decrease of LOS (p<0.001), exposure to antiviral, and antibiotic agents decreased significantly (p < 0.001, each). Insourcing of ME-PCR and CXCL 13 shortened the time-span from admission to diagnosis in patients with suspected inflammatory CNS disease from 13.6 (6.6) to 9.7 (6.7) days in mean (SD).

CONCLUSION: The shortened average LOS after changing the diagnostic pathway increased direct costs for test kits. However, these costs were by far outweighed the economical benefit of being able to treat more patients in the same time. This analysis should be replicated in a different Medical Care System than the one in which this analysis has been calculated.

PMID:40542447 | DOI:10.1186/s42466-025-00398-9

Eur J Med Res. 2025 Jun 20;30(1):502. doi: 10.1186/s40001-025-02698-x.

ABSTRACT

INTRODUCTION: This study investigated the association between the financial performance of workplaces and the incidence of occupational injuries and diseases using the Workplace Panel Survey, a workplace-related national statistical survey in South Korea.

METHODS: The dependent variables were those related to the incidence of occupational injuries and diseases. The independent variables were those related to the financial performance of each workplace. Multilevel Poisson regression (or logistic regression) and linear regression analyses were used.

RESULTS: For the number of victims, the average number of workers, interest income, interest expenses, and value-added per person were associated with a significantly increased relative risk (RR). In contrast, lease expense2, depreciation and amortization, and initial/ending industrial property rights were associated with a significant decrease in RR. For the existence of occupational injuries/diseases, taxes and duties1, and welfare/benefits expenses were associated with a significant increase in the odds ratio (OR). In contrast, severance pay2, depreciation/amortization, and average number of workers were associated with a significant decrease in OR.

DISCUSSION: As the financial status of workplaces worsened, the incidence of occupational injuries and diseases increased. In contrast, as the operating profit and amount of tangible assets (subject to depreciation and amortization) of workplaces increased, the incidence of occupational injuries and diseases decreased. As the number of workers increased, the number of occupational injuries and diseases also increased; however, the odds of occupational injury or disease decreased. The decreasing number of occupationally injured or diseased workers, along with the increasing number of transport devices, might have resulted from special consignment subcontracts between cargo truck owners and shipping companies in South Korea.

PMID:40542441 | DOI:10.1186/s40001-025-02698-x

Eur J Med Res. 2025 Jun 20;30(1):499. doi: 10.1186/s40001-025-02783-1.

ABSTRACT

OBJECTIVES: To explore the latest characteristics and diagnostic methods of renal tuberculosis, and to improve the new recognition and diagnostic level of renal tuberculosis.

METHODS: We collected the medical records and postoperative histopathological slides of 217 patients diagnosed and treated with renal tuberculosis in the Department of Urology of Hebei Provincial Chest Hospital from March 25, 2013 to February 6, 2024, and divided them into the typical group (145 cases) and the atypical group (72 cases) according to their onset characteristics, and analyzed the distribution of onset symptoms and the differences in the positive rates of different examination methods between these two groups.

RESULTS: (1) Frequency, urgency and pain of urination were the main symptoms in the typical group (66.82%), and local or systemic atypical symptoms in the atypical group (33.18%), and the incidence rate of women in the atypical group was higher than that in the typical group (P < 0.05). (2) In both groups, the positive rate of CT diagnosis of renal tuberculosis was higher than that of ultrasound and urography (P < 0.05), and there was no statistically significant difference between the positive rates of T-SPOT.TB and PPD tests (P > 0.05). The CT positivity rate in the typical group was higher than that in the atypical group (P < 0.05). In the typical group GeneXpert MTB/RIF had a higher positive rate than that of PCR TB-DNA, acid-fast staining and tuberculosis culture (P < 0.05). However, in the atypical group and all patients in both groups, there was no statistical difference between the positivity rates of GeneXpert MTB/RIF and PCR TB-DNA (P > 0.05), both of which were higher than those of acid-fast staining and TB culture (P < 0.05). The positivity rate of acid-fast staining and tuberculosis culture was higher in the typical group than that in the atypical group (P < 0.05). In the typical group, the positivity rate of LAM antibody was higher than that of 38KDa and 16KDa (P < 0.05). However, in the atypical group, there was no statistically significant difference between the positivity rates of 38KDa and LAM antibodies (P > 0.05), and both were higher than that of 16KDa antibodies (P < 0.05). (3) There was no significant difference in pathological changes between the two groups, both of which were dominated by granulomas and caseous necrosis, and the positivity of tissue PCR TB-DNA was higher than that of antacid staining (P < 0.05), but there was no statistically significant difference in the positivity of tissue PCR TB-DNA between the two groups (P > 0.05). Cystoscopic biopsy was dominated by granuloma and necrosis in the typical group and chronic inflammation in the atypical group.

CONCLUSIONS: (1) In addition to renal tuberculosis with bladder irritation as the main clinical manifestation, atypical renal tuberculosis is also an important part of renal tuberculosis, which is characterized by systemic or local atypical symptoms, and should be highly concerned. (2) CT, GeneXpert MTB/RIF, T-SPOT.TB (or PPD test) and LAM antibody have higher sensitivity both in typical and atypical renal tuberculosis, which can improve the diagnosis rate of renal tuberculosis. (3) There is no significant difference in the pathologic changes between typical and atypical renal tuberculosis, and PCR TB-DNA of the tissues may help to improve the pathologic diagnosis of renal tuberculosis. In atypical renal tuberculosis, bladder mucosal lesions are characterized by chronic inflammation, and cystoscopic biopsy alone is of low diagnostic value.

PMID:40542434 | DOI:10.1186/s40001-025-02783-1

Orphanet J Rare Dis. 2025 Jun 20;20(1):312. doi: 10.1186/s13023-025-03854-6.

ABSTRACT

BACKGROUND: Ehlers-Danlos Syndrome (EDS) comprises connective tissue disorders associated with increased vascular complication risks. This meta-analysis assesses the prevalence of vascular complications in among patients with EDS.

METHODS: The review was conducted following PRISMA guidelines. A comprehensive literature search was conducted in PubMed, Embase, and Web of Science until November 2024. Observational studies reporting vascular complications in EDS were included. Data extraction included demographics, complication types, and study design, and quality assessment was evaluated using the modified Newcastle-Ottawa Scale (NOS). Random-effects models and I² statistics assessed heterogeneity, while Doi plots evaluated publication bias.

RESULTS: Of the 1,772 articles screened, 12 met the inclusion criteria, reporting various vascular complications in EDS. The overall pooled prevalence of vascular complications was 30.03% (95% CI: 15.00-51.07%). The prevalence for the vEDS subtype was 42.36% (95% CI: 12.63-78.88%), for unspecified EDS was 18.65% (95% CI: 5.38-48.03%), and for hEDS was 19.77% (95% CI: 15.09-25.16%). Sensitivity analyses confirmed the stability of the pooled prevalence estimates, and DOI plots indicated minimal publication bias.

CONCLUSIONS: This review highlights the high risk of vascular complications in vEDS, with moderate involvement in other EDS subtypes. Regular vascular monitoring, especially in vEDS, is crucial for early detection and intervention. Standardized diagnostic protocols and further research into genetic factors are needed to improve management strategies.

PMID:40542421 | DOI:10.1186/s13023-025-03854-6

Ital J Pediatr. 2025 Jun 20;51(1):196. doi: 10.1186/s13052-025-01988-8.

ABSTRACT

BACKGROUND: We aimed to compare endotracheal intubation through a laryngeal mask vs. using a direct laryngoscope in a manikin simulating a term infant.

METHODS: A randomized, controlled, crossover (AB/BA) trial of intubation through a laryngeal mask vs. a direct laryngoscope in a manikin simulating a term infant. Thirty-four tertiary neonatal intensive care unit consultants and pediatric residents who had previous experience with intubating laryngeal airway and direct laryngoscopy participated. The primary outcome measure was the success of the procedure at the first attempt. The secondary outcome measures included the total time of endotracheal tube positioning and participant’s opinion on insertion difficulty and overall difficulty.

RESULTS: Success at first attempt was 34/34 with the laryngeal mask (100%) and 26/34 with the direct laryngoscope (76%) (difference in percentage 24%, 95% confidence interval 5-41%; p = 0.008). Median time of endotracheal tube positioning was 24 s (IQR 19-30) with both devices (p = 0.86). Insertion difficulty (p = 0.96) and overall difficulty (p = 0.99) were not statistically different between the devices.

CONCLUSIONS: In a term infant manikin model, positioning the endotracheal tube through the laryngeal mask increased the success at the first attempt compared to direct laryngoscopy, without extending the duration of the procedure or affecting the perceived difficulty.

REGISTRATION: clinicaltrial.gov NCT06263790. Registered 16 February 2024, https://clinicaltrials.gov/study/NCT06263790 .

PMID:40542416 | DOI:10.1186/s13052-025-01988-8